British journal of preventive & social medicine最新文献

Analysis ofthe proportional mortality attributed to ischaemic heart disease, adjusted for age, reminds us that many of the well known geographical, environmental, social, and economic variations within England and Wales are not disease specific.

Blood lead levels in some pre-schoolchildren living near a lead works and particularly in some children with fathers employed at the lead works showed evidence of increased exposure. Forty-seven of them took part three years later in a follow-up study of their developmental and behavioural functions. The children were aged between 4 and 5 1/2 years and were closely matched for age, sex, social class, parental education, area, and length of residence. Only three children had moved house since their blood lead levels had been examined at two years of age; these levels ranged between 18 and 64 microgram/100 ml. None of the children had clinical symptoms of plumbism. No statistically significant (P less than or equal to 0.05) differences were found on developmental and behavioural scores when the children were divided into two groups of less than or equal to 35 microgram/100 ml (n = 23) and greater than 35 microgram/100 ml (n = 24). The differences in scores were of the same order as those between boys and girls, which were themselves generally not significant. Behaviour ratings did not differ. The variations in developmental skills were generally found to be more related to age and schooling; neither these factors nor the difference in sex was related to blood lead levels.

Children with cleft lip and/or palate born during the period 1965-74 inclusive in the Oxford area were examined for evidence of any tendency for clustering. The methods suggested by Knox (1963), David and Barton (1966), and Smith and Pike (1974) were used. No clustering was evident in space or in time. There was some indication of clustering in space-time for isolated cleft palate during the period 1965-71, but this was not repeated during 1972-74.

This study was designed to investigate personal and social factors associated with demand for care by women aged between 20 and 44 years, a group unlikely to suffer from chronic illness. A random sample of women was drawn from the age-sex register of a south London group practice, and information was obtained concerning their daily symptom perception, anxiety level, social and health characteristics, and their consultations for one year. Social class, family involvement, number of children in household, satisfaction with the housing, and use of other health and social services were not associated with demand for general practitioner care. Absence of basic housing amenities, difficulties in running the household, brevity of stay in the house or neighbourhood, and lack of attachment of the neighbourhood were related to a high patient-initiated consultation rate. Some of the possible interpretations of these results are discussed together with their implications for social policy planning.

A study was undertaken into the obstetric services of a health district to find out whether the new purpose-built obstetric accommodation was still needed and, if so, the best method for bringing it into use. If it was not required for its original purpose it was hoped that the study would reveal an alternative use. It was also hoped that the study would answer any further questions that might emerge from the investigation. The study showed that the purpose-built obstetric accommodation was not a present required. It was recommended that the 22 obstetric beds should be used for gynaecology and that the accommondation upgraded earlier for that purpose should form part of the geriatric provision.

This is the initial report of a longitudinal study conducted in a developing, culturally heterogeneous society. The study compares figures of frequency and length of perceived illness, subjective reports of biological and behavioural symptoms, and use of medical facilities in response to episodes of illness by female heads of households from two highly distinctive social-ethnic groups. Despite differences in socioeconomic status and cultural beliefs about disease and treatment, both groups showed roughly comparable rates of perceived illness, but certain differences were noted. The more prosperous Western group termed ladinos, showed they had had more illness which had also lasted longer, as well as higher levels of symptoms. The medical actions of the two groups in response to these episodes of illness differed. The significance of these results is discussed with respect to the multiplicity of factors which influence health status and judgements of perceived illness.